Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 22003 | SC |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 200201427 | NC |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 22003 | SC |
NPI | 1396745485 |
---|---|
Provider Name | Dr. Anthony Wayne Alexander |
First Address | Florence, SC 29505-6080 |
Second Address | Florence, SC 29505-6080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 29/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89063NO | N.C. MEDICAID (01) | |
E96750-1271 | (02) | SC |
T59068 | (05) | SC |